Cholera

Cholera

Cholera is an acute diarrhoeal disease caused by V . Cholera (Classical El. Tor)

Causative organism - Vibrio Cholera

Mode of transmission

Transmission occurs from man to man via 

a. Faecal contaminated water

b. Contaminated food and water 

c. Direct contact

Incubation period - Few hours to 5 days

Clinical manifestations

Onset is abrupt with profuse, painless, watery diarrhea known as rice water stool.

·  Muscular cramps

·  In Children – Fever, convulsions or coma, loss of muscular tone.

·  Vomiting

·  Sunken Eyes

·  Hallow checks

·  Skin pale

·  Husky voice

·  Extremities are cold.

·  Pulse rapid and feable.

·  Blood pressure is low

·  Shallow and quick respiration

Diagnosis

Stool test

Complications

·  Shock,

·  Severe dehydration,

·  Low blood sugar in children which can cause seizures, unconsciousness, and even death

·  hypokalemia(low potassium level)

Control measure

1.  Verification of the diagnosis : All cases of diarrhea should be investigated .

2. Notification : Cholera is a notifiable disease locally, nationally and internationally. Health workers at all levels should be trained to identify and notify cases immediately to the local health authority.

3.  Early case finding : An aggressive search for case (mild, moderate, severe) should be made in the community to be able to initiate prompt treatment.

4.  Establishment of treatment centers : In the control of cholera, no time should be lost in providing treatment for the patients.

·  Easily accessible treatment facilities in the community

·  Treatment for dehydration

·  For Mild dehydration - treatment at home with oral rehydration fluid.

·  For Severely dehydrated patients requires intravenous fluids in a nearest treatment centre or hospital.

·  When it is endemic or threatening - mobile teams should be established.

5.  Epidemiological investigations to study the extent of the outbreak and identify the modes of transmission.

6.  Sanitation measures

·  Water Sanitation

·  Excreta Disposal - Health education messages should stress the proper use of such facilities.

·  Food sanitation - Sale of foods under hygienic conditions. Health education regarding eating cooked hot food, and proper food handling techniques.

· Disinfection: Most effective disinfectant is bleaching powder. Clothes and personal items to be disinfected with disinfectant (dettol).

7.    Health Education regarding Oral Rehydration therapy, Early diagnosis and adequate treatment and Food sanitation

Treatment

Replacement of fluids and Electrolytes.

·  Antibiotics

·  Anti diarrheal drugs

·  Rehydration therapy : The oral rehydration therapy and intra venous fluids (IVF).

·  Vaccination to protect the people from Cholera.